How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,259 to $11,482Professionalmedian $1,413 · 10th to 90th $1,000 to $4,365
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,454.71 Median $5,623.41 Typical High $13,803.84 | Facility | None | $2,454.71 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $2,511.89 | Professional | None | $912.01 | $912.01 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,258.93 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,479.11 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $2,187.76 Typical High $2,818.38 | Professional | 50 · Both sides | $1,548.82 | $2,187.76 | $2,818.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,412.54 | Professional | None | $912.01 | $1,000.00 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $5,248.07 | Facility | None | $1,202.26 | $3,801.89 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $2,344.23 | Professional | None | $954.99 | $1,174.90 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,258.93 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $2,344.23 Typical High $8,511.38 | Professional | None | $1,071.52 | $2,344.23 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,412.54 | $2,344.23 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | 52 · Reduced service | $457.09 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $223.87 | Professional | 53 · Discontinued | $181.97 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $676.08 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $165.96 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $776.25 |
Where Missouri sits
The same service costs 3.6 times more in Alaska than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $11,248MT $3,134
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.